This article was originally published on AdvocateDaily on August 19, 2015.
Ontario’s Liberal government — through proposed changes to the province’s auto insurance system and recent regulation amendments — has dealt several blows to plaintiffs that are certain to make life more difficult for injured individuals, says Toronto personal injury lawyer Emily Casey.
In its spring budget, Ontario’s Liberal government proposed combining services related to catastrophic injuries, like attendant care and rehabilitation, to a single benefit with a limit of $1 million, down from the current combined $2-million limit, reports the CBC.
Basic auto insurance benefits are also targeted by the changes, says the CBC article, noting the government is looking to combine medical and rehabilitation benefits with attendant care services as a single benefit set at $65,000. Separately, the benefits used to total more than $80,000.
For non-catastrophically injured individuals, the time to claim the benefits would also be cut in half — five years instead of the current 10, the report continues.
The changes are part of an effort by the Liberals to reduce the costs of auto insurance, reports the CBC.
The budget also saw changes to Ontario Regulation 461/96, which was amended to provide for an inflation-indexed deductible for damages related to pain and suffering loss. The deductible amounts will now be indexed to reflect the effects of inflation since 2003.
Casey, an associate with Tkatch & Associates, says the raft of changes are concerning for several reasons.
“When I have clients come in who have had a car accident and are considering starting a claim, I explain the two schemes to them. In Ontario, we go through accident benefits — that’s where you’re claiming benefits for things like lost income, cost of physiotherapy, or any kind of medical treatment needed as a result of an accident. You don’t claim this through the driver of the car that hit you; you claim it through your own car insurance if you have it.”
The other side, Casey explains, involves starting a lawsuit where a plaintiff sues the driver who they feel is at fault for the accident.
“In both schemes, most clients have no idea how to navigate the system and no idea how the law works,” she says. “They’re usually very surprised to learn they’ve paid into insurance premiums only to find out they’re getting much less for those premiums than they would have assumed or would have 10 to 15 years ago. The recent incoming changes are making things even worse.”
Many members of the public are pleased to hear the government’s promise of lower premiums, says Casey, without realizing that many benefits are being cut each time new legislation is rolled out.
“They are often surprised to hear, for example, that in many cases with soft tissue injuries, they will be placed in the Minor Injury Guideline (MIG) with a maximum of $3,500 coverage for treatment, which is exhausted very quickly when one attends physio three times a week,” she says.
The reality is, especially with the most recent proposed changes, that the government will be left to pick up the shortfall when injured individuals can’t afford care, says Casey.
“One million dollars for a catastrophically injured individual is going to be exhausted very quickly, and then the burden goes to the government,” she says. “A lot of these changes will take pressure off insurance companies and put it on OHIP.”
When it comes to the recent regulation change to allow for inflation-indexed deductible amounts, Casey says the benefits being received should be indexed for inflation as well.
“The income replacement benefit, for example, is not indexed for inflation,” she says. “It’s just not sensible to say certain things need to be indexed for inflation over time, but anything that can benefit the insured isn’t going to be.”
Until now, a $30,000 deductible applied to all awards for pain and suffering below $100,000, says Casey, noting the changes put the deductible at $36,540 until Dec. 31, when the amount will be revised for inflation again.
“This is very stressful for injured individuals,” she says. “I have yet to see any change that’s beneficial to an insured person. Given the fact that all the rhetoric has been about protecting the insured, it seems that none of the changes have reached that objective.”
And oftentimes, says Casey, individuals don’t understand how these legislative changes impact them until they’re in the thick of a claim.
“There’s not a lot of transparency for an insured person,” she says. “People don’t understand this scheme until they’re in it, and then it’s too late.”
